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Feasibility and Optimization of Aortic Valve Planimetry with MDCT

Suhny Abbara1, Antonio J. Pena, Paul Maurovich-Horvat, Javed Butler, David E. Sosnovik, Alexander Lembcke, Ricardo C. Cury, Udo Hoffmann, Maros Ferencik and Thomas J. Brady

1 All authors: Department of Radiology, Massachusetts General Hospital, 165 Cambridge St., Ste. 400, Boston, MA 02114.


Figure 1
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  		Fig. 1A —Aortic valve images in 52-year-old man with coronary artery disease. Multiphasic images reconstructed for dynamic assessment show aortic valve through entire cardiac cycle.

 

Figure 2
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  		Fig. 1B —Aortic valve images in 52-year-old man with coronary artery disease. Multiphasic images reconstructed for dynamic assessment show aortic valve through entire cardiac cycle.

 

Figure 3
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  		Fig. 2A —Aortic valve reconstructions in systolic phases. Separate data sets reconstructed at acquisition windows starting at 0-200 milliseconds after R peak in 61-year-old man with coronary artery disease were obtained for planimetric orifice measurement. Acquisition windows are 105-210 milliseconds wide (gantry rotation of 420 milliseconds, multisegment reconstruction depending on heart rate).

 

Figure 4
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  		Fig. 2B —Aortic valve reconstructions in systolic phases. Images of 54-year-old woman with coronary artery disease show example of closed valve at 200-millisecond phase start and double-leaflet sign at 150 milliseconds.

 

Figure 5
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  		Fig. 3A —Aortic planimetry in 53-year-old man with coronary artery disease. Area of aortic valve opening is measured by tracing inner border of aortic cusps (dotted line, B).

 

Figure 6
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  		Fig. 3B —Aortic planimetry in 53-year-old man with coronary artery disease. Area of aortic valve opening is measured by tracing inner border of aortic cusps (dotted line, B).

 

Figure 7
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  		Fig. 4 —Bar graph shows largest aortic valve orifice area was found at phase starts of 50-150 milliseconds (ms) after R peak in most (81%) cases.

 

Figure 8
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  		Fig. 5 —Bar graph shows that, similar to aortic orifice opening, best overall image quality was seen 50 milliseconds (ms) after R wave peak in most cases.

 

Figure 9
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  		Fig. 6 —Bar graph shows highest prevalence of artifacts was observed in earliest (phase start of 0 milliseconds [ms]) and latest (phase start of 200 milliseconds) systolic phases, whereas midsystolic phases (50-150 milliseconds) exhibit relatively little image artifact. Gray bars show percentage of cases with doublecontour artifacts, and black bars show percentage of cases with incomplete contour artifacts.

 

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